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Symptoms predictive of Fusobacterium necrophorum pharyngotonsillitis - an observational study of cases presenting to hospitals in Southern Sweden.
Pagels, Josefina; Torisson, Gustav; Wasserstrom, Lisa; Hedin, Katarina; Holm, Karin; Nygren, David.
Afiliación
  • Pagels J; Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden. josefina.pagels@gmail.com.
  • Torisson G; Department of Infectious Diseases, Skåne University Hospital, Lund/Malmö, Sweden. josefina.pagels@gmail.com.
  • Wasserstrom L; Department of Infectious Diseases, Skåne University Hospital, Lund/Malmö, Sweden.
  • Hedin K; Clinical Infection Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden.
  • Holm K; Department of Clinical Microbiology, Infection Control and Prevention, Skåne University Hospital, Lund, Sweden.
  • Nygren D; Clinical Microbiology, Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden.
Eur J Clin Microbiol Infect Dis ; 43(6): 1099-1107, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38609699
ABSTRACT

OBJECTIVES:

Fusobacterium necrophorum is a common cause of pharyngotonsillitis. However, no guidelines exist on when to diagnose or treat it. We aimed to investigate associations between clinical criteria and F. necrophorum-positivity in pharyngotonsillitis and assess the predictive potential of a simple scoring system.

METHODS:

Pharyngotonsillitis patients who were tested for F. necrophorum (PCR) and presented to hospitals in the Skåne Region, Sweden, between 2013-2020 were eligible. Data were retrieved from electronic chart reviews and registries. By logistic regression we investigated associations between F. necrophorum-positivity and pre-specified criteria age 13-30 years, symptom duration ≤ 3 days, absence of viral symptoms (e.g. cough, coryza), fever, tonsillar swelling/exudate, lymphadenopathy and CRP ≥ 50 mg/L. In secondary analyses, associated variables were weighted by strength of association into a score and its predictive accuracy of F. necrophorum was assessed.

RESULTS:

Among 561 cases included, 184 (33%) had F. necrophorum, which was associated with the following criteria age 13-30, symptom duration ≤ 3 days, absence of viral symptoms, tonsillar swelling/exudate and CRP ≥ 50 mg/L. Age 13-30 had the strongest association (OR5.7 95%CI 3.7-8.8). After weighting, these five variables had a sensitivity and specificity of 68% and 71% respectively to predict F. necrophorum-positivity at the proposed cut-off.

CONCLUSION:

Our results suggest that F. necrophorum cases presenting to hospitals might be better distinguished from other pharyngotonsillitis cases by a simple scoring system presented, with age 13-30 being the strongest predictor for F. necrophorum. Prospective studies, involving primary care settings, are needed to evaluate generalisability of findings beyond cases presenting to hospitals.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Faringitis / Tonsilitis / Infecciones por Fusobacterium / Fusobacterium necrophorum Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Eur J Clin Microbiol Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Suecia

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Faringitis / Tonsilitis / Infecciones por Fusobacterium / Fusobacterium necrophorum Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Eur J Clin Microbiol Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Suecia